Diagnostic Dilemma #1
The first in our series of clinical cases with difficult management questions…
Question: 59 y.o. male with pmh notable for hyperlipidemia. Pt had normal lft's, which increased mildly when he was put on a statin. His basic hepatitis screen including A, B and C were all negative, but an iron/tibc was 61% with a nl ferritin. A hemochromatosis gene analysis was sent which revealed a single mutation c282y-and he was designated a carrier. U/s showed a midly heterogeneous hepatic echotexture with no discrete lesions.
1: would you stop the statin?
2. would you consider phlebotomy?
3. would you consider a liver bx given his heterogeneous hepatic echotexture?
4. what's his longterm prognosis?